PCI

Il «Gramsci creolo», nasce a Marcaria, nell’entroterra mantovano, nel 1926. La sua è una vita intensa, fatta di Resistenza e politica internazionale. A soli 17 anni, raggiunge la Brigata partigiana autonoma “Vicenza”,  sale sui Monti Lessini e col nome di battaglia “Nadia” (in russo “speranza”) combatte i nazifascisti. Per il suo coraggio gli verrà riconosciuta la Medaglia di Bronzo al Valor Militare. Il 25 aprile 1945 è a Milano come guardia del corpo di Sandro Pertini.

The concept of Non Performing Assets was first introduced by the Narsimham Committee (1991) on "Financial Sector Reforms". Public Sector Banks (PSBs) have always faced the problem of rising NPAs year after year. The deterioration of NPAs is primarily driven by the public sector banks. Many reasons are attributed to the heavy debt piling of PSBs such as, improper evaluation at the appraisal stage of borrower screening, irregular monitoring of loans, deficiencies in the recovery mechanism, etc. Creditors had weak rights and hence the recovery rate was very low. The problem of NPAs has been a hindrance in the economic development of the country. For measuring the effects of NPAs, we have to assess the performance of banking sector with respect to the factors of economic development. This research article studies the phenomenal deterioration of stressed asset quality, raising potential losses for not making enough provisions to combat the NPAs in the Indian Banking sector. The article observes that over the period of time, NPAs and bad loans have been adding in a spiralling manner in Indian Banks. Despite the treatment of stressed assets and prompt corrective actions as per asset quality report by regulators, the results are appearing at a very slow pace. They are of the opinion that strength and sustainability of the credit growth is the need for robust banking in the times to come.

This study evaluated the outcomes of patients discharged the day of percutaneous coronary intervention (PCI) by analyzing the data from a single-center, large, multioperator registry of interventions.Although same-day discharge is likely safe after interventions on low-risk stable patients, there is limited data to guide selection of a broader population of patients. Due to numerous patient variables and physician preferences, standardization of the length of stay after PCI has been a challenge. Most of the reported studies on same-day discharge have strict inclusion criteria and hence do not truly reflect a real-world population.We analyzed the outcomes of consecutive same-day discharge in 2,400 of 16,585 patients who underwent elective PCI without any procedural or hospital complication. Composite end point included 30-day major adverse cardiac cerebral events and bleeding/vascular complications.The mean age of the study population was 57.0 ± 23.7 years with 12% aged over 65 years. Twenty-eight percent received glycoprotein IIb/IIIa inhibitor with closure devices in 90.5%. Clinical and angiographic success was noted in 97% of all PCIs. The average length-of-stay following PCI was 8.2 ± 2.5 h. The composite end point was reached in 23 patients (0.96%). Major adverse cardiac cerebral events occurred in 8 patients (0.33%) and vascular/bleeding complications in the form of Thrombolysis In Myocardial Infarction minor bleeding in 14 patients (0.58%) and pseudoaneurysm in 1 patient (0.04%).When appropriately selected, with strict adherence to the set protocol, same-day discharge after uncomplicated elective PCI is safe despite using femoral access in a wide spectrum of patients.

ABSTRACT An experimental testing program was conducted at Kansas State University (KSU) to test the bond characteristics of various 5.32 mm-diameter, Grade 270 low-relaxation steel wires used in prestressed concrete railroad ties. This un-tensioned pullout test could serve as a quality control test similar to the NASP (North American Strand Producers) Strand Bond Test that has been developed for pre-tensioned strands. A total of twelve (12) wires produced by six different steel manufacturers were used to develop the wire pullout test. All of the wires were tested in their " as-received " condition and have different indent geometries. It is generally accepted that indentations in the wire improve the bond between the steel and concrete. However, there are currently no commonly accepted quality control tests that accurately predict a wire's bond characteristics in a pre-tensioned application. The un-tensioned pullout test developed is comparable to the NASP [Strand] Bond Test. The specimens consist of a 4 in. (100 mm) outer-diameter tube with a total length of 8 in. (200 mm) and a steel plate welded to the bottom. The 5.32 mm-diameter wire was centered in the tube and the sand-cement mortar was placed and allowed to cure. The flow of the mortar was measured for consistency and 2 " x 2 " (50 mm x 50 mm) mortar cubes were used to determine the compressive strength of the mortar. The specimens were tested when the compressive strength of the mortar was between 4500 and 5000 psi (31.0 MPa and 34.5 MPa). Each batch of mortar contained 12 pullout specimens; one with each wire type. Each wire was tested six times leading to a total of six batches and a total of 72 mortar specimens. During testing, the wires were loaded in force control at the bottom, while continuously monitoring and recording the movement (slip) of the wire with respect to the mortar at the opposite (top) end. The force verses end-slip data of the six tests for each wire type were numerically combined to obtain the average bond performance. These average results from the un-tensioned pullout tests were then compared to transfer length measurements from accompanying pre-tensioned concrete prisms. In general, the wire end slip measurements from the pullout tests were found to have good correlation with the measured transfer length. For all 12 wires, a coefficient of determination (R 2) of 0.872 was found between the average pullout force (at 0.10-inch (2.54 mm) of wire free-end slip) and average transfer length measurements from the accompanying concrete prism tests. However, when only the indented wires were considered, the R 2 increased to 0.913.

This paper presents a full-scale experimental study of two precast concrete moment-frame assemblies, each comprising three columns and two beams. The assemblies represented portions of seismically designed perimeter moment frames from two 10-story prototype buildings. One assembly was part of an ordinary moment frame, and the other was part of a special moment frame. The assemblies were subjected to monotonically increasing vertical displacement of the unsupported center column to observe their behavior and failure modes under simulated column removal. The failures of both the ordinary moment frame and special moment frame specimens were characterized by fracture of the bottom anchorage bars at the welded connection to the center column and diagonal cracking and shear deformation of the end columns under outward forces generated by arching action in the beams. Additional failure modes included shear stud failure for the ordinary moment frame specimen and bond failure of anchorage ba...

Um dos principais objetivos da inventariação de elementos do Património Cultural Imaterial (PCI) é o registo sistematizado e a organização do conhecimento produzido sobre esse património. O art.º 12.º da Convenção (UNESCO, 2003) refere a necessidade de se promoverem os inventários PCI e qualquer elemento candidato à inscrição numa das duas listas mundiais do PCI tem, obrigatoriamente, de figurar num Inventário. Muito por esse motivo, nos últimos 10 anos, iniciaram-se vários processos de inventariação e, para respeitar a recomendação do acesso público, o recurso à Web tornou-se uma opção lógica. O Mapa dos e-inventários do Património Cultural Imaterial apresentado neste artigo permite aceder diretamente a 158 e-inventários a partir dos links assinalados nos países onde estes foram realizados. Neste artigo apresenta-se uma análise preliminar de alguns dados que caracterizam esses inventários e apela-se à participação na revisão e atualização deste mapeamento.

Cardiocerebral resuscitation (CCR) is a new approach for resuscitation of patients with cardiac arrest. It is composed of 3 components: 1) continuous chest compressions for bystander resuscitation; 2) a new emergency medical services (EMS) algorithm; and 3) aggressive post-resuscitation care. The first 2 components of CCR were first instituted in 2003 in Tucson, Arizona; in 2004 in the Rock and Walworth counties of Wisconsin; and in 2005 in the Phoenix, Arizona, metropolitan area. The CCR method has been shown to dramatically improve survival in the subset of patients most likely to survive: those with witnessed arrest and shockable rhythm on arrival of EMS. The CCR method advocates continuous chest compressions without mouth-to-mouth ventilations for witnessed cardiac arrest. It advocates either prompt or delayed defibrillation, based on the 3-phase time-sensitive model of ventricular fibrillation (VF) articulated by Weisfeldt and Becker. For bystanders with access to automated external defibrillators and EMS personnel who arrive during the electrical phase (i.e., the first 4 or 5 min of VF arrest), the delivery of prompt defibrillator shock is recommended. However, EMS personnel most often arrive after the electrical phase—in the circulatory phase of VF arrest. During the circulatory phase of VF arrest, the fibrillating myocardium has used up much of its energy stores, and chest compressions that perfuse the heart are mandatory prior to and immediately after a defibrillator shock. Endotracheal intubation is delayed, excessive ventilations are avoided, and early-administration epinephrine is advocated.

After the end of the World War II, the SPD undertook a deep transformation, evolving from a «workers part» to a «citizens party», which aimed at building a «Western» form of democratic socialism. This process culminated in the Congress of Bad Godesberg, when the SPD formally abandoned its Marxist tradition. The consequences were twofold. On the one hand, the Spd represented itself as a responsible political force that could credibly enter the government. On the other, the Spd began to pressure and encourage other European Social Democratic forces to follow the «German model», and marginalize the Communist parties operating in their domestic political systems. This was the case of 1970s’ Italy, where the Spd played a substantial role in influencing the Psi’s transition, particularly after the election of Bettino Craxi as General Secretary.

Anti-thrombotic drugs constitute the cornerstone of therapy in the management of acute coronary syndromes (ACS) and for patients undergoing percutaneous coronary intervention. Anti-thrombotic therapy during percutaneous coronary intervention for ACS has evolved substantially over the past 15 years. In the original 1996 ACC/AHA guidelines for the management of acute myocardial infarction (MI), only one antiplatelet agent (aspirin) and one anticoagulant (unfractionated heparin) were recommended as class I therapies. Much has since changed and the contemporary therapeutic armoury for the treatment of ACS reflects the pharmacological advances that have taken place. Recent developments in the medical management of ACS have been based around developing drugs with more predictable efficacy and at known drug targets. However there has also been considerable development of novel agents. New pharmacotherapies for ACS reflect efforts to improve efficacy and minimize complications by increasing...

Prestressed concrete wing-shaped members are frequently used in the construction of long-span roofs in precast concrete buildings. Roofs spanning more than 30 m (100 ft) are built by assembling a number of these thin-walled members. To optimize their design and take advantage of their potential load-carrying capacity, the transfer of large forces from the pretensioned strands to the concrete is critical. Information on the evolution of these forces and of the ensuing deformations is necessary, not only in the long run, but also immediately after concrete casting and during the first few weeks. The Department of Civil and Environmental Engineering of the University of Perugia in Italy and a major prefabrication firm of central Italy have completed an experimental program on pretensioned wing-shaped members to investigate the evolution of prestressing stresses and of camber during the different stages of concrete hardening. The result allowed the careful evaluation of the prestress lo...

Louw A, Diener I, Butler DS, Puentedura EJ. The effect of neuroscience education on pain, disability, anxiety, and stress in chronic musculoskeletal pain.To evaluate the evidence for the effectiveness of neuroscience education (NE) for pain, disability, anxiety, and stress in chronic musculoskeletal (MSK) pain.Systematic searches were conducted on Biomed Central,BMJ.com, CINAHL, the Cochrane Library, NLM Central Gateway, OVID, ProQuest (Digital Dissertations), PsycInfo, PubMed/Medline, ScienceDirect, and Web of Science. Secondary searching (PEARLing) was undertaken, whereby reference lists of the selected articles were reviewed for additional references not identified in the primary search.All experimental studies including randomized controlled trials (RCTs), nonrandomized clinical trials, and case series evaluating the effect of NE on pain, disability, anxiety, and stress for chronic MSK pain were considered for inclusion. Additional limitations: studies published in English, published within the last 10 years, and patients older than 18 years. No limitations were set on specific outcome measures of pain, disability, anxiety, and stress.Data were extracted using the participants, interventions, comparison, and outcomes (PICO) approach.Methodological quality was assessed by 2 reviewers using the Critical Review Form–Quantitative Studies. This review includes 8 studies comprising 6 high-quality RCTs, 1 pseudo-RCT, and 1 comparative study involving 401 subjects. Most articles were of good quality, with no studies rated as poor or fair. Heterogeneity across the studies with respect to participants, interventions evaluated, and outcome measures used prevented meta-analyses. Narrative synthesis of results, based on effect size, established compelling evidence that NE may be effective in reducing pain ratings, increasing function, addressing catastrophization, and improving movement in chronic MSK pain.For chronic MSK pain disorders, there is compelling evidence that an educational strategy addressing neurophysiology and neurobiology of pain can have a positive effect on pain, disability, catastrophization, and physical performance.

Abstract In this paper, a new approach for car license plate detection will be presented. The proposed method is faster than previous methods as it avoids time-consuming image transformations such as Hough transform, Fourier transform, wavelet transform, etc. The suggested method is based on modified mathematical template matching and colour analysis to detect the location of the car's plate. This new method detects all plates in a matching cycle using avoidance dynamic templates such as classic template matching ...

Patients receiving oral anticoagulation (OAC) who undergo drug-eluting stent (DES) implantation require additional dual antiplatelet therapy with aspirin and clopidogrel. Such triple therapy confers an elevated bleeding risk, and its optimal duration is not known. The goal of this study was to evaluate whether shortening the duration of clopidogrel therapy from 6 months to 6 weeks after DES implantation was associated with a superior net clinical outcome in patients receiving concomitant aspirin and OAC. In this randomized, open-label trial, we enrolled patients receiving OAC who underwent DES implantation at 3 European centers between September 2008 and December 2013. A total of 614 patients receiving concomitant aspirin and OAC were randomized to either 6-week clopidogrel therapy (n = 307) or 6-month clopidogrel therapy (n = 307). The primary endpoint was a composite of death, myocardial infarction (MI), definite stent thrombosis, stroke, or Thrombolysis In Myocardial Infarction (...

Incomplete stent apposition (ISA) is characterized by the lack of contact of at least 1 stent strut with the vessel wall in a segment not overlying a side branch; it is more commonly found in drug-eluting stents than bare-metal stents. The accurate diagnosis of ISA, initially only possible with intravascular ultrasound, can currently be performed with higher accuracy by optical coherence tomography, which also enables strut-level assessment due to its higher axial resolution. Different circumstances related both to the index procedure and to vascular healing might influence ISA occurrence. Although several histopathology and clinical studies linked ISA to stent thrombosis, potential selection bias precluded definitive conclusions. Initial studies usually performed single time point assessments comparing overall ISA percentage and magnitude in different groups (i.e., stent type), thus hampering a comprehensive understanding of its relationship with vascular healing. Serial intravascu...